Depressed women may be at a risk of having a stroke, according to recent study of more than 80,000 women.
The study found that those with a history of depression had a 29 percent increased risk of stroke.
Women who used anti-depressant medication such as selective serotonin reuptake inhibitors had a 39 percent increased risk of getting a stroke. Examples of these drugs are Prozac, Zoloft, and Celexa.
The research can be found in the journal Stroke: Journal of the American Heart Association.
Dr. Kathryn Rexrode, the study's senior author and associate physician at Brigham and Women's Hospital in Boston, Mass., said anti-depressant medication use may be an indicator of depression severity.
"I don't think the medications themselves are the primary cause of the risk," she said in a statement. "This study does not suggest that people should stop their medications to reduce the risk of stroke."
The researchers followed 80,574 women 54 and 79 years in the Nurses' Health Study from 2000 to 2006, who were without a prior history of stroke. They assessed depressive symptoms multiple times and anti-depressant use was reported every two years beginning in 1996, and physicians diagnosed depression beginning in 2000.
Twenty-two percent of the women had been diagnosed with depression, and 1,033 stroke cases were documented during six years of follow-up, according to the study.
When compared to women without a history of depression, depressed women were more likely to be single, smokers and less physically active. They were also slightly younger, had a higher body mass index and more coexisting conditions such as high blood pressure, heart disease and diabetes, researchers found.
"Depression can prevent individuals from controlling other medical problems such as diabetes and hypertension, from taking medications regularly or pursuing other healthy lifestyle measures such as exercise," Rexrode said. "All these factors could contribute to increased risk."
Depression may be associated with an increased risk of stroke through various mechanisms. It may be linked to inflammation, which increases the risk of stroke as well as other conditions or underlying vascular disease in the brain, said An Pan, lead author of the study and a research scientist at the Harvard School of Public Health, in a statement. "Regardless of the mechanism, recognizing that depressed individuals may be at a higher risk of stroke may help the physician focus on not only treating the depression, but treating stroke risk factors such as hypertension, diabetes and elevated cholesterol as well as addressing lifestyle behaviors such as smoking and exercise."
But the study had its limitations, as the participants were predominantly white registered nurses and it excluded women without detailed information on depression measures and the participants with onset of stroke at a young age.
"We cannot infer cause or fully exclude the possibility that the results could be explained by other unmeasured unknown factors," Pan said. "Although the underlying mechanisms remain unclear, recognizing that depressed women may be at a higher risk of stroke merits additional research into preventive strategies in this group."